A couple of weeks ago, I was the attending nephrologist for our hospital consultation service when I met Mr. Jones. He had suffered a severe heart attack. His heart was stunned into stillness and couldn’t effectively pump oxygen-filled blood to his kidneys or any of his other parts for the however many minutes it took for the ambulance to get to him and start resuscitation. Once he was transferred to the hospital, the cardiologists successfully reopened the major coronary artery responsible for the attack, but his kidneys weren’t working as well as they had been before. But his kidneys were the least of his troubles. My interaction with his family reminded me of an experience in my own life from about twenty years prior.
I had just finished presenting my body of research for the prior six years in hopes of convincing the committee I was worthy of promotion from Assistant to Associate Professor of Medicine when the chairperson said, “It is clear palliative care is your passion, so you should stop wasting your time with the dental research." I. Should. Stop. Wasting. My. Time.
The nurse practitioner exhaled completely as she plopped down next to me in the clinic workroom — as if she had used up her last bit of energy. She had spent the last hour with a 75-year-old man with severe chronic kidney disease.
The distress call came to me fourth-hand in the form of an email. The colleague of a colleague’s wife’s father wondered if I could help because the father was contemplating stopping the peritoneal dialysis his wife had been helping him do at home for the last several years.